Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

Do things that matter. Diabetes, congestive heart failure, COPD, back pain, asthma, pulmonary fibrosis, chronic kidney disease, Alzheimer's, multiple sclerosis, cancer... everyone knows someone affected by these conditions. Our goal is to decrease cost and improve health for members with chronic disease. We do this by using data science and advanced analytics (e.g., condition specific predictive models and clinical data mining) to improve their care journeys and outcomes, focusing on the right members getting the right interventions at the right time.

Mission aligned to improve health. With 1,000+ health hubs, 1,100+ minute clinics, 23M+ lives insured by Aetna, and 100M+ lives with pharmacy benefits coverage through Caremark. With this unique collection of assets, CVS Health has an unparalleled platform to make a significant impact on healthcare in the US and beyond.

We have actual big data. The combined data assets of CVS are massive: medical and pharmacy claims, health care records, commercial store, and transactional data for 100M+ members. The scale of our data will allow you to design and test powerful experiments and challenge yourself to innovate in ways that others simply cannot.

An elite team. You’ll be joining a team of MDs, PhDs, MBAs, and top analytics professionals that bring their clinical, technical, and economic experience to bear on some of the toughest targets in healthcare.

Focus of the Position (PBM Analytics)

Our PBM Analytics team is tasked with optimizing our ability to engage with our 100M+ Caremark members to help them make better healthcare decisions, particularly relating to the medications they take. Our goals are to improve clinical outcomes and to help members gain more transparency into the healthcare system so that they can save money and have better experiences. To do this we’ve developed a leading capability that combines data science, agile marketing, behavioral economics, large scale experimentation, and optimization of our digital capabilities. Through this we message millions of members each year about real challenges they face and help them become healthier or save money – we drive tangible and meaningful impact for our members.

• This role is required to fulfill the Enterprise goals of effective cost management through managing the aggregate financial impact of PBM products, initiatives, and contracts on pharmacy cost trend.

• The team’s goal is to provide timely, accurate, actionable data and analysis for utilization and unit cost management to reduce pharmacy cost for our clients: quantifying how our various products and programs (e.g., utilization management) are impacting pharmacy cost trends, and helping prioritize actions that would lead to further cost improvements across Commercial and other lines of business.

• Support the evaluation and implementation of enterprise initiatives to respond to pharmacy cost pressures and mitigate unfavorable drivers of business performance.

• Support regular trend analyses and material development for department reporting and meetings.

• Deliver performance evaluation and business-impacting recommendations for cost savings analytics.

• Assist in identifying critical pharmacy cost issues and design and recommend solutions to business problems to staff, senior Executive leadership, and key business partners

• Work cross-functionally across a diverse stakeholder group including: Product, Clinical, Finance, Trade, Medical Economics, Data Science, and Actuarial

Required Qualifications

• 1+ years with Healthcare Analytics, Medical/Pharmacy Cost Analytics, Data Science, Actuarial Science

• 1+ years working in a role with competing priorities and working cross-functionally

Preferred Qualifications

• Strong analytical ability and familiarity with advanced financial and healthcare concepts. Demonstrates critical thinking, and problem solving, and expresses ideas clearly, concisely, and logically from a cross functional perspective.

• Familiar with or is willing to learn some of the most popular advanced analytics such as machine learning, statistical analyses, and predictive modeling.

• Well versed in advanced analytics tools and languages to analyze large data sets from multiple data sources.

• Demonstrates a strong ability to communicate technical concepts and implications to business partners.

• Foundational knowledge of PBM business functions, including underwriting, sales, product development, network management, and trade

• Anticipates and prevents problems and roadblocks before they occur.

Education

Bachelor's degree in quantitative field, or equivalent experience in Mathematics, Statistics, Computer Science, Business Analytics, Engineering, actuarial science, or related discipline. Master's degree preferred.

Pay Range

The typical pay range for this role is:

$79,310.00 - $158,620.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit Benefits | CVS Health (https://jobs.cvshealth.com/us/en/benefits)

We anticipate the application window for this opening will close on: 01/10/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.